Headphones

Jim Durkel, CCC SLP / A School for the Blind and Visually Impaired Texas Outreach Program

Summary: This article provides basic information about hearing aids, assistive listening devices and cochlear implants and what are most appropriate for children with deafblindness and additional disabilities.

Keywords: programming, deafblindness, hearing aids, assistive listening devices, cochlear implants.

A hearing aid is a device that helps a person with hearing loss to have better access to sounds. Some early devices were huge horns or trumpets and the person who used them holding the smaller end in your ear and the larger end pointing toward the person who spoke to him. The good news is that hearing aids have become more sophisticated and useful for people from that time. The bad news is that hearing aids have increased their cost and are based on fine electronics that often needs repair, especially when used by a young child!

Today's hearing aids use batteries for power, have microphones to capture the sounds, have circuitry that make sounds louder and somehow manage to get the modified sound to the ear of the user.

SIZE of headphones and how to use them

The first way to classify by size hearing aids and the manner in which they are used.

The largest instrument called body aid. A body aid is roughly the size of a pack of cigarettes. Usually held in the user's chest with a special harness or is carried in the breast pocket. This type of headphone used to be necessary for people who need big power, but as technology has improved and not used very often. Body aids need to be connected to the user's ear with ear molds. Get a headset cable and connected to the mold with a locking ring.

BTEs that is, that are worn behind the ear (BTE for short) are the most common type of headphones used by children. The hearing device fits behind the ear of the child and is connected to the ear through the use of an earmold. BTE hearing aids have the advantage of being small, but still are able to develop the necessary power.

BTE hearing aids have a compartment housing a battery, a switch on / off and volume control. Sometimes the switch on / off is also a position with the brand T. We'll talk about this position.

The BTE has a curved piece of hard plastic that leaves the headset and connects with earmold tubes. This part is called hook tone (tone hook). Sometimes changing the size and shape of the hook tone can help the BTE best suits the user.

It's easy to lose BTEs because they are very small. Another problem is that even though these headphones are small can be large compared with the head of a small child.Sometimes the ear simply not large enough to hold the BTE in the child's head. Fortunately, you can do some things to solve the problem. Setting the tone hook or mold can often help hold the headset more firmly in the child's ear. There is also a tube called "Huggy" that connects to the headset and helps hold in the head.

The other types of hearing aids are the Ear (ITE), Canal (ITC) and completely-Canal (CIC). These smaller aids do not have as much power as BTE and are generally not recommended for children. These headphones are small and not very noticeable when worn. However, the hearing aid is embedded in the ear mold. When you need a new ear mold, the user should be without headset. Furthermore, due to the small size of the hearing aid, you need a very good fine motor control to operate the switches and change the batteries.

CIRCUITS

Until recently, all hearing aids used analog circuits. What is important to know about these headphones is that although very powerful, such as headsets were not adjustable digital hearing aids that are newer (and more expensive).

Set a hearing aid is the process of ensuring that the instrument is correct for the user's hearing loss. The first part of a hearing aid is adjusted to obtain a good audiogram. We want to know at what level of intensity (decibels or dB) the user can simply detect whether or not a sound mind. This is what is called the threshold. Thresholds need through the speech frequency range of 250 Hz (low-pitched sounds) to 8000 Hz (high-pitched sounds). The Hertz is a frequency measurement and abbreviated Hz determined the threshold having the person without the headphones, then look what we would like the threshold. The difference is how much "profit" we need at that frequency. We and adjust the headset to give us just the right amount of gain for each frequency tested. This is why it is important to have an unaided audiogram and then re-run in the headset, that allows us to measure the actual gain that the user is getting.

If the user can repeat words, it is better to make a word discrimination test with and without the hearing aid. During the word discrimination test, the user repeats a word list and the percentage of correctly repeated words is the word

discrimination score. If the word discrimination score does not improve significantly, the hearing aid is best for the user.Unfortunately children, especially those who are small or multiple disabilities, can not do word discrimination tests. Consequently, the patient's audiogram with and without hearing aids are even more important to find the type of hearing aid that best suits these children.

Although both analog and digital hearing aids can be programmed, like hearing aids do not allow an adjustment of the gain as accurate as digital. Digital hearing aids have some "bells and whistles" additional analog hearing aids can not offer. For example, digital hearing aids do a better job of detecting and filtering noise. Digital hearing aids can also have a feature that helps prevent feedback (whistling) that can occur when ear molds do not fit well.

Many hearing aids have a feature known as compression. Compression means that the hearing aid will amplify soft sounds more than loud sounds. Uncompressed, the headset will make loud sounds even louder. This can be painful and irritating to the person wearing the headset.

Some hearing aids can have multiple programs. That is, the user can select a setting to listen when sounds are softer and a different setting for listening in noise.

Generally, set the instrument so that the user use the volume control roughly in half. This gives the least amount of distortion. If the user is constantly changing the volume control, this may indicate that the headset did not fit him properly.

MICROPHONES

All headphones use microphones to capture ambient sounds. In typical auditory systems, we have two hearing devices that capture sounds. Generally it is best if the user has two microphones at ear level. Having a microphone on each side of the head support with an important ability auditory localization. Localization is the ability to know where in space a sound is coming. This skill is used during training in orientation and mobility.

In body aids, these microphones are located on the headset and therefore are at chest level user. This provision does not allow a good location.

BTE hearing aids can be directional or omnidirectional microphones. Omnidirectional microphones pick up sounds more or less equivalent to 360 degrees. Directional microphones pick up sounds that go to the front of the instrument rather than the sounds coming from other directions. Directional microphones can improve hearing in noisy environments, but can be difficult to navigate location.

Headsets and assistive listening

Even with the most sophisticated hearing aids, hearing in noise is always difficult. The location may be affected. Follow conversations in a large group is a rather difficult listening situation. You may need assistive listening devices or aids audion (AML for short) in conjunction with the hearing aid to help solve some of these problems.<http://www.tsbvi.edu/Outreach/seehear/winter03/ald.htm> Visit for more information on the ALD .

Remember the T position switch controls? T stands for telecoil. This is an alternative way to enter the sound to the headset. Within the earphone is a coil which can receive electromagnetic energy. Older phones used to let out that energy and hearing aid manufacturers were advantage of this fact to help hearing aid users to use the phone more efficiently. Today, you should make a special order for phone to release this energy. Children use the T position more often to connect the headset to an assistive listening device.

There are other ways to connect a headset to an assistive listening device, such as using a "boot" (boot). This is a connection on the headset that allows it to be directly connected to an ALD. There are some headphones that are built to receive information from a remote microphone, the ALD is incorporated. It is generally preferable to use a personal hearing aid with an ALD together instead of using the ALD like personal hearing aid. This is because hearing aids can usually be better individualized than an ALD.

BATTERIES

Depending on the type of hearing aid and the amount of time per day the user to use, the typical battery life is 5 to 7 days. Batteries may sell out at any time, so it's always good to have spares on hand. Batteries for hearing aids may seem like candy to small children, so be careful of disposing of used batteries. Sometimes, it is cheaper to join a hearing aid battery club where you can buy batteries with discounts and free packages for several packages purchased.

Earmolds

All body and BTE hearing aids require a separate earmold. The mold fits tightly in the ear. It is necessary for ear molds are custom made to the hearing aid. They come in different materials and colors. It is not uncommon for children to need a new earmold every 6 months or so since, as the child grows, the mold is no longer a good fit to your ear.

If a child has middle ear infections, may have feedback with the headset even when the ear mold fits well. If a child has an infection in the ear canal, it can be painful to wear ear mold. Sometimes, hearing aid users have allergic reactions to an ear mold material and must be returned to produce the mold in another material.

You can make several modifications to the ear mold to make it lighter, more comfortable and more suitable for hearing loss of an individual child. Talk to your audiologist or hearing aid dealer if the ear mold is apparently causing discomfort to the child. Sometimes, the mold just needs some polishing to remove a small, but irritating rough spot.

Need cleaning earmolds regularly. It is common for accumulating and cerumen blocking the mold. You can use a soft ware detergent and warm water to clean the mold. Be sure to allow the mold to dry completely before using.

The ear molds can be lubricated to help them get into the child's ear. Do not use petroleum-based products such as Vaseline, this may cause some mold materials disintegrate.

LEARN TO USE THE HEADSET

The hearing aids do not restore normal hearing or fail. They help make some sounds are available to the user. It is unreasonable to think that simply just put a hearing aid to a child and that this device will worry about hearing loss of that child.

It may take some time for the child to get used to using the headset. The ear molds can be uncomfortable to wear, but over time the hearing aid user learns to ignore. The headphones deliver the child auditory information that he never had before. First, this information can be overwhelming and frightening to the child. Children may need some specific training to learn the use of new information that provides the hearing aid hearing.

Auditory training is an important part in learning to use the headset. This includes not only learn to use auditory information obtained through the headset, but also learn how to care for the device itself.

HOW TO BUY AND HOLD A HEARING AID

The life of a hearing aid, even if it is well maintained, is five to seven years. Hearing aids are worn and when used by children are subject to abuse pretty! Always a good idea to purchase insurance when buying headphones. This insurance covers the costs of repair and / or replacement of lost hearing.

Hearing aids can cost anywhere from several hundred to several thousand dollars. Sometimes private insurance will cover the cost of hearing aids. For families who meet the eligibility requirements for Medicaid (the state health insurance in Texas). Texas has a program known as PACT (Program for Amplification for Children of Texas) administered through the Department of Health. For more information on PACT, visit <http://www.tdh.state.tx.us/audio/pact.htm>. Families who do not meet the eligibility requirements for Medicaid and have no private insurance can explore community resources such as Lions and Soroptimist clubs. For deafblind children, the Commission for the Blind of Texas can support families to find resources to help cover the cost of hearing aids. Of course, the local teacher of students with hearing impairments can also help you find local resources.

Children with hearing aids should undergo hearing tests with and without hearing aids at least once a year. We want to ensure that the child's hearing has not changed and that the instrument remains adequate for the child.

A hearing aid can only be beneficial if it is right, if used consistently and constantly and working in peak condition. This means that operation of the instrument should be checked daily. <http://www.tsbvi.edu/Outreach/seehear/spring00/hearingaids.htm> Visit for more information on how to check the headphones .

COCHLEAR IMPLANTS

Sometimes hearing loss can be so large that it is possible that conventional headphones not delivering sufficient benefits. If the threshold is not reached with the headphones are at least 30 decibels or less at 2000 Hertz, it may be time to consider using a cochlear implant. This is not a decision taken lightly and requires consideration of many factors that go beyond just the thresholds achieved with and without hearing aids.

CHILDREN WITH MULTIPLE DISABILITIES

Children with multiple disabilities, including deafblindness, have different considerations for hearing aids for children who only have hearing loss.

Get good audiogram of the patient (with and without hearing aids) may require more time and effort. Team building is important to help make this happen.

Team building is also important to consider the impact of the use of hearing aids in orientation and mobility training or the use of assistive technology.

Team building is necessary to discuss the impact of the use of headphones when physical disabilities. For example, use a BTE hearing aid while in a

wheelchair with head support can produce much feedback. In this situation, it might be more appropriate to use a body aid. Some children have no where to put one ear earmold and may require the use of a bone conduction hearing aid.

Finally, team building is important to ensure that all adults who come into contact with the child using a headset understands the importance of consistent use of it, you understand what to expect from listening skills and how to handle child-related problems the use of this device.

It is important to remember that if a child needs a hearing aid, that child should have prevented educational classification of auditory (AI) and have a teacher for students with hearing impairments. This teacher should be able to serve as an information source and as a coordinator on issues related to audiological testing and hearing aids.

Hearing aids, whether they are adequate and used properly, can open up a whole new world for our children with hearing loss!